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MAXSURGE DENTAL SPECIALIST PLLC NPI 1205255403


NPI Information

NPI: 1205255403
Provider Name: MAXSURGE DENTAL SPECIALIST PLLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
520 N PINE ST
HARRISON, AR
ZIP 72601
Phone: (870) 741-3877
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MAXSURGE DENTAL SPECIALIST PLLC is an oral and maxillofacial surgery dentist in Harrison, AR. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. MAXSURGE DENTAL SPECIALIST PLLC NPI is 1205255403. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

520 N PINE ST
HARRISON, AR
ZIP 72601-442
Phone: (870) 741-3877
Fax: (870) 741-2406

The provider's authorized official is Scott L Bolding .
The authorized official title is Owner and has the following contact phone number (479) 717-1171.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 4/21/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery3025ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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